During the performance of micro-surgical procedures such as eye surgery, it is essential that the instruments used in and around the surgical field be held stationary, and that the surgeon's hands and arms be firmly supported when delicate and precise manipulations of instruments such as scalpel incisions are made. An inadvertent movement of an instrument or of the surgeon's arms can result in an unsuccessful operation or further injury to the patient. For a long time surgeons struggled with adapting standard surgical room equipment for use in micro-surgical procedures and obtained only limited success. Problems which were encountered included insufficient stability of the support devices and a lack of adequate adjustability to bring the surgeon's arms into comfortable positions for the operation. Also, there was no convenient place to lay instruments beside the surgical field, and no convenient way to hold the drape off the nose and mouth of the patient.
Many of the problems encountered in providing satisfactory micro-surgical support devices and instrument holding capabilities were remedied by my Arm And Hand Rest Device For Micro-Surgery, U.S. Pat. No. 4,018,217, issued Apr. 19, 1977. The device disclosed in that patent provides stable support for the surgeon's hands and arms by utilizing a board placed on the operating table beneath the patient, so that the weight of the patient holds the device firmly in place on the operating table. Legs extend upwardly from the board on each side of the area where the patient's head rests, and tables on top of the legs support the arms and/or hands of the surgeon and hold instruments so that they are readily accessible. Adjustment of the supporting surfaces is achieved by moving the patient, or the tables may be raised and lowered by turning a nut engaged on a threaded shaft in the two-part legs supporting each table.
When performing some surgical procedures the surgeon often desires to make adjustments in the height of the supporting tables during the course of the operation. Vertical adjustment can be achieved with my Arm And Hand Rest Device For Micro-Surgery; however, the adjustment procedure is often slow. When adjustment is done during an operation it is desirable that it be made quickly, and the adjustment apparatus must have a secure, fail-safe locking mechanism so that slippage of the supporting table will not occur. Further, it has been found that angular displacement of the supporting tables with respect to the board beneath the patient is often desirable. Different surgical techniques often require various arm positions for performance. Whereas one surgeon may desire to have his arms supported on a surface generally parallel with the board beneath the patient, another surgeon, or the same surgeon performing a different operation or using a different technique, may desire to have his arm supported on a surface which is angular with respect to the board beneath the patient. Hence, an angular adjustment mechanism for each of the arm rest tables is desirable, and as in the vertical adjustment mechanism, a fail-safe locking apparatus is required for the angular adjustment mechanism to prevent inadvertent movement of the tables during an operation. Further, the horizontal adjustment mechanism should enable the surgical assistants to quickly adjust the table and secure it in the adjusted position.